Evaluation of a hypertonic sodium chloride/dextran solution for treatment of traumatic shock in dogs

Abstract

Objective— To compare the efficacy of 7% NaCI solution (hypertonic saline) in 6% dextran 70 solution (HSD) with that of lactated Ringer's solution (LRS) for treatment of dogs in traumatic shock. Design— Prospective, randomized, clinical study. Animals— 16 traumatized adult dogs with clinical signs of shock. Procedure— Physical, hemodynamic, blood gas, and clinical chemistry measurements were performed prior to treatment. Initial treatment consisted of HSD (n = 8) or LRS (n = 8) administered as a bolus (5 ml/kg of body weight, IV) over a 3-minute period, followed by administration of additional LRS and other treatments to restore hemodynamic and physical criteria to within reference limits. Measurements were repeated for 3 hours after initial treatment. The volumes of LRS and HSD administered were recorded hourly. Degree of injury was scored by using a trauma severity index. Results— Dogs responded similarly to the treatments, and all but 3 dogs survived to be discharged. The amount of fluid administered to dogs in the HSD group over the final 2 hours of the study was significantly less than that administered to the dogs in the LRS group. Serum sodium concentration and osmolality of the dogs in the HSD group were not significantly greater than those values in the LRS group. Bradyarrhythmias were observed in 2 dogs in the HSD group. Clinical Implications— Hypertonic sodium chloride/ dextran solution is safe and effective for resuscitating dogs in traumatic shock. Seven percent NaCI in 6% dextran 70 may reduce the need for isotonic fluids in the hours after initial resuscitation. (J Am Vet Med Assoc 1996;208:366-370)